JOURNAL OF SOCIAL HISTORY, Volume 27: Pages 737-757,
Spring 2003.

The masturbation taboo and the rise of routine male
circumcision:
A review of the historiography - Review Essay

Robert Darby

Although it is becoming rare as a routine
procedure on newborn males, circumcision in both a medical
and cultural/religious context has been the focus of
increasing attention from medical historians. With the
publication of David Gollaher's path-breaking investigations
into its history, international efforts to ban the
circumcision of women (female genital mutilation) as
performed by some traditional Islamic and east African
cultures, continuing protests against the survival of routine
circumcision of male infants in the United States and parts
of Canada, and a contrasting campaign on the part of some
medical conservatives in Britain, the USA and Australia to
restore the practice as a public health measure, scholarly
interest in the origins and evolution of "the world's most
controversial surgery" has never been more intense. Not that
many definitive answers have emerged. Contrary to the mantra
which opens nearly every article on the subject in medical
journals (that circumcision is the oldest surgical operat ion
known to man, practised by many ancient cultures etc),
circumcision as a medically rationalised procedure is a
recent invention, dating from the eighteenth century. Even as
a religious ritual, circumcision was practised by only a few
tribal societies, mostly living in desert regions: the
Semtitic and Hamitic peoples of north and east Africa and the
Middle East, and the Aboriginal people of central Australia
are the most notable. (1) Therapeutic
circumcision was first introduced as a treatment for severe
venereal infection of the penis (often causing scabs which
fused the foreskin to the glans) and was no more than a
last-ditch amputation of incurably diseased tissue; even then
it was not performed often because most men were reluctant to
lose part of their most prized possession. (2) The concept of circumcision as a
preventive, and then routine, procedure emerged in the
mid-nineteenth century, though the reasons for this
development remain contested. In a recent historical survey,
Dunsmuir and Gordon cite prevention or cure of impotence,
phimosis, sterility, priapism, masturbation, venereal
disease, epilepsy, bed-wetting, night terrors, "precocious
sexual unrest" and homosexuality as among the contradictory
benefits urged by Victorian and Edwardian physicians in
Britain and the USA, without offering any firm suggestions of
their own as to the relative weight of these factors. (3) Circumcision as a "routine" (that is,
involuntary) operation on male infants was practised only in
the English-speaking world; in its place of origin, Britain,
it lasted only from the 1870s to the 1940s and probably
affected no more than a third of boys at its peak--points
which emphasise the importance of cultural and religious
factors in explaining its rise and fall. (4) Other authorities, however, stress the
medical origins and continuing value of the procedure as a
health precaution. According to Brian Morris, "the Victorians
cited many of the same medical conditions associated with
uncircumcised penises as do people today," while the idea
that mass circumcision was introduced in the nineteenth
century to discourage boys from masturbating is "in fact a
falsehood that has been promoted by anti-circumcision
groups." (5) As a contemporary champion of
the routine circumcision of male infants, Professor Morris is
very critical of the unscientific approach of
anti-circumcision activists, but it is strange to see him
endorsing the Victorian enthusiasm for circumcision as
consistent with today's arguments in its favour, yet denying
that control of masturbation had anything to do with the
matter.

It is this issue that I wish to address
here. By means of a review of the historiography of both the
masturbation phobia and the rise of routine circumcision I
hope to shed light on how significant the aim of preventing
masturbation was in this process. To anticipate my
conclusions, I shall argue that it has been widely accepted
by medical historians since the 1950s that discouraging
masturbation was a major reason why doctors, educationists
and childcare experts sought to introduce widespread
circumcision of both boys and girls in the nineteenth
century, a campaign which was successful in the former case,
unsuccessful in the latter--an outcome which still colours
popular concepts about what constitutes genital mutilation. I
suggest that a result of the partial character of this
victory has been a high degree of blindness on the issue:
while the treatment of hysteria and masturbation in women by
clitoridectomy was noticed early on (and condemned with
indignation), the comparable operation on boys (amputation of
the foreskin) has been either ignored or given only fleeting
attention, and has rarely been regarded with the same degree
of abhorrence. I will also attempt to show the theological
basis for much of the medical argument against masturbation
and suggest that moral concern has always been an important
element of the motivation for circumcision.

In searching for the link between the
Western prohibition of childhood masturbation and the rise of
routine circumcision, the psychoanalysts seem to have been
the first on the trail. In a study of children with
psychological and behavioural problems in the 1930s, Mabel
Huschka reported that a high proportion of the boys had been
threatened with mutilating operations on their penis if they
masturbated. In her introduction to the data she makes
reference to a small sample of medical literature which
recommended circumcision for girls who persisted in the
habit, and a rather more popular German book which recorded
that some doctors "armed with great knives and scissors"
threaten boys with a "painful operation or even to cut off
the genital organs." The same authority added that "small
operations" were sometimes helpful: one physician "cured a
young fellow in whom ... no punishment had proved effective,
by simply cutting off the anterior part of the foreskin with
jagged scissors." He also mentioned infibulation a nd
chastity cages to block access to the penis. (6) Huschka seems unaware that infant male
circumcision had become quite common in the USA by the 1930s
(between 50 and 60 per cent of newborns--about the same as
today), (7) but the high incidence of
mutilation threats received by boys, mostly picturing "the
doctor" coming to cut their penis in some unspecified but
painful way, would be possible only in a medical culture in
which the surgical removal of (part of) the penis was
frequently recommended and widely performed. There are no
reports of such horror stories before the nineteenth century,
and the cautionary tale for children with which these threats
share the most affinity, "The story of little suck-a-thumb,"
in Heinrich Hoffmann's Struwwelpeter, was not published until
1847, near the height of the masturbation scare in Germany.
(8) Discussing the prevalence of flogging
in nineteenth century England, Ian Gibson comments that
threats of castration for many varieties of bad behaviour,
including playing with the genitals, were "probably not
uncommon" and adds: "Circumcision, too, must have also seemed
a castration threat to many children and been looked upon as
a terrible punishment for having a penis." (9) It would seem that the boys' fears were no
more than an expression of medical/moral realities.

After the war, in a much-cited article, Rene
Spitz surveyed the medical literature on masturbation and
related the increasing condemnation the practice to
traditional Christian prohibitions against non-procreative
sex and the publication of two alarmist texts in the
eighteenth century: the anonymous Onania, or the heinous sin
of self pollution (c. 1716), and Simon-Andre Tissot's
Onanism, or a treatise on the disorders produced by
masturbation (1758), from which nearly all the nineteenth
century's invective against "solitary vice" can be sourced.
(10) Spitz quantified the greater
prominence of punitive methods in the treatment of
masturbation, in both girls and boys, in anglophone
countries, and observed that "sadism" became "the foremost
characteristic of the campaign" in the second half of the
nineteenth century, including such "drastic measures" as
surgery, restraint, severe punishment and fright; the surgery
included blistering of the genitals, clitoridectomy in girls
and circumcision in boys. (11) Spitz notes
that circumcision was consistently urged as a disincentive to
masturbation in successive editions of L. Emmett Holt's
influential textbook on paediatrics, The care and feeding of
children, from 1895 until 1936, and points out that it was
"not generally known that these sadistic practices found
support among many authoritative physicians and ... were
recommended up to a decade ago in official textbooks." They
were not the obsession of a lunatic fringe. (12)

A decade later, in an article cited even
more often than that by Spitz, R.M. Hare traced the history
of the masturbation phobia in more detail, especially the
idea that it caused neuroses and insanity, a proposition
which survived longer in Britain and the USA than in Europe.
(13) In this connection Hare drew
attention to the importance of Claude-Francois Lallemand
(1790-1853), Professor of Medicine at Montpellier, whose
3-volume work Involuntary seminal losses (1836-42) seemed to
confirm the reality of a disease later called spermatorrhoea.
To cure this condition, which was often caused by
masturbation, Lallemand recommended cauterisation of the
urethra with silver nitrate, and circumcision in cases where
the problem was the result of an excessively long or
sensitive foreskin, and he exerted an enduring influence on
British doctors, particularly William Acton. On the question
of treatment, Hare observed that, by the second half of the
nineteenth century, "surgical and pharmacological methods of
preventing ma sturbation were certainly widespread,"
mentioning depressant drugs and chastity devices for both
sexes; infibulation of the foreskin, castration and severing
the dorsal nerve of the penis in males; and clitoridectomy
and ovariotomy in females. But he concluded that these
interventions were either ineffective or too extreme to win
wide acceptance. Like Spitz, he was horrified by the brief
vogue for clitoridectomy which flared in Britain in the
1860s, but relegated to a footnote his awareness that the
eminent surgeon and expert on syphilis, (Sir) Jonathan
Hutchinson, in his well known paper "On circumcision as a
preventive of masturbation," nor only advocated universal
circumcision of male infants, but considered that "measures
more radical than circumcision would, if public opinion
permitted their adoption, be a true kindness to many patients
of both sexes." (14) Hare's reticence on
the growing acceptance of the compromise procedure on boys,
which promised to curb undue lust while leaving the
reproductive func tion intact, is puzzling.

The sceptical mood and anti-puritanism of
the 1960s found expression in Alex Comfort's light-hearted
but reliable survey of medical manias, The anxiety makers
(1967). "curious preoccupations of the profession" he listed
the crusade for continence, an obsession with constipation,
hostility to drinking tea, moralistic theories of venereal
disease and the campaign against self-abuse. Following Spitz
and Hare, Comfort observed that punitive treatments for the
vice introduced in the second half of the nineteenth century
included chastity belts and genital infibulation for both
sexes, and spiked collars to wrap around the penis of boys
afflicted by nocturnal emissions, as recommended by J.L.
Milton in his much-reprinted book on spermatorrhoea. (15) Comfort was more interested in and
shocked by clitoridectomy than the circumcision of boys, but
he points out that the latter was regularly recommended as a
prophylactic against masturbation, notably by Jonathan
Hutchinson. Comfort also drew attention to P.C. Remondino's
tub-thumping advocacy of mass circumcision in his History
of circumcision from the earliest times to the present: Moral
and physical reasons for its performance (1891),
according to which the procedure would not only discourage
boys from masturbating, but immunise them against
tuberculosis, cancer, syphilis, polio, idiocy, forgetfulness
and just about any medical problem you cared to mention.
Comfort makes the now obvious but then novel point that
belief in the health benefits of circumcision is really the
belief that the portion of the penis cut off is by nature
pathogenic, an assumption which lay behind the medical
profession's endorsement of routine circumcision in the
nineteenth century, and which received forceful expression in
Remondino's manifesto, where the foreskin is vilified, at
tedious length, as a malign influence and moral "outlaw." (16)

Even more sceptical than Comfort was Thomas
Szasz, who compared the cruel treatment of masturbators in
the nineteenth century with the persecution of witches at an
earlier period and related the obsession with masturbation as
a illness-generating vice to the decline in the belief that
diseases were the result of divine punishment for sin or the
operations of witchcraft; in an age trying to be scientific,
but when the cause of diseases was not understood, blaming
them on personal habits was both morally satisfying and
consistent with the "nerve force" theories then being
developed by Albrecht von Haller (1708-77) and William Cullen
(1710-90) as alternatives to traditional explanations based
on humoral balance which stretched back to Hippocrates and
Galen. (17) Szasz also pointed out that
much of the medical analysis of masturbation was no more than
moral exhortation dressed in medical rhetoric. He accepted as
an uncontroversial fact that "mutilating surgical operations
on the penis" were standard sanctions against masturbation,
citing both Hutchinson's paper, including his suggestion of
castration in chronic cases, and E.J. Spratling's equally
extreme tactic of cutting the dorsal nerve of the penis.
Szasz identified a paradox in surgical treatment of the habit
becoming more frequent as belief in the theory of
masturbatory insanity declined, and explains this by
suggesting that the phenomenon was related to "the
development of surgical skills and aseptic operating
techniques which allowed safe surgical mutilations1" not to
new medical indications. (18) Szasz also
recorded the persistence of the advice to circumcise as a
precaution against masturbation in textbooks such as Emmett
Holt's and found the same recommendation in Griffith and
Mitchell's Diseases of infants and children (1938). They
present a paradox he was unable to explain: although they
admit that masturbation does little damage, even when
indulged in "to an extreme degree," they devote a page to
treatments and conclude by endorsing circumcision for both
boys and girls as a wise precaution. (19)

H. Tristram Engelhardt further developed
Spitz's and MacDonald's (20) point that
masturbation was originally sin rather than sickness by
exploring the process by which a religious transgression was
transformed into a medical disease without losing any of its
immoral connotations, and drawing attention to the punitive
character of the therapies evolved. He applied the ironic
term "heroic methods" to cover such treatments as
infibulation of the foreskin, vasectomy, cauterisation of the
urethra, insertion of electrodes into the bladder and rectum,
puncturing the prostate with needles, castration and
circumcision. (21) Engelhardt does not go
into as much detail on the last of these as his sources
warrant, and tends to leave the impression that it was a rare
intervention instead of the routine procedure it soon became,
but at least he identified it as a mainstream response to the
problem. Arthur Gilbert provided further evidence on such
remedies and also the nature of the diseases that
masturbation was supposed to provoke. He suggested that the
centrality of masturbation in accounts of organic disease was
related to doctors' rising prestige and their tendency to
take over the role of the priest; the cycle of sin,
confession, penance and redemption was transferred from
confessional to consulting room. At the same time, there was
very little that physicians could actually do about most
diseases, and blaming them on masturbation was often found
more satisfactory than admitting their own impotence. (22) Despite this, the authority of the
medical profession increased steadily during the nineteenth
century, and in 1889 an article in the Lancer compared them
to "the old type of priests who combined moral and medical
functions." (23)

The moral mission of the medical profession
was also the focus of a densely researched but little known
paper by Ronald Hamowy, who shows how US doctors in the late
nineteenth century successfully extended their ambit from the
cure of disease to the enforcement of puritanical standards
of sexual morality, and exerted a powerful influence on
public law. He argues that psychological medicine, in
particular, substituted the treatment of disease for the
punishment of moral transgression and became both the arbiter
and enforcer of virtuous conduct. By the end of the century,
he suggests, it had succeeded in convincing the literate
public as to the connection between sexual conduct and mental
disease and been able to persuade US legislatures to pass
laws which embodied the conclusions of the medical profession
and "criminalize[d] sexual immorality under the guise of
legislating in the area of preventive medicine." (24) Hamowy documents the remedies proposed
for masturbation, and goes into greater detail than many w
riters on the use of clitoridectomy in girls, and
infibulation, chastity devices and castration in boys. Among
other examples, he describes a case in 1894 when eleven boys
confined in a Kansas mental institute were castrated for
persistent masturbation; when the local press raised an
outcry at such severity, the Kansas Medical Journal
defended the institute's action on the ground that the boys
were confirmed masturbators.... This abuse weakened the
already imbecile mind and destroyed the body. The practice is
loathsome, disgusting, humiliating and destructive of all
self-respect and decency, and had a bad moral effect on the
whole school.

It was backed up by doctors from all over
the country. (25) The puzzling omission
from Hamowy's account is any discussion of circumcision. Many
of the dozens of medical articles he cites (for example,
those by C. Frank Lydston, E.J. Spratling and George Beard)
are explicit and detailed about the preventive and curative
value of such a therapy, and indeed regard it as the primary
weapon, but Hamowy's only mention of it is in the form of an
allusion by Lydston, who in 1893 called for the castration of
"sex perverts," especially Negro rapists, "if the operation
be supplemented by penile mutilation according to the
Oriental method." (26) Hamowy does not
explicate this roundabout reference to circumcision, nor
suggest why Lydston felt it was a necessary adjunct to
castration in the control of Negroes. His discussion is thus
not as complete as it could and, given his sources, should
have been, but his detailed and fully documented discussion
of castration alone should have made it impossible for later
historians of nineteenth century sexuality to make bland
statements such as this by Thomas Laqueur: "There was no male
castration, no removal of healthy testes, except in a few
rare and quite specific instances for criminal insanity or to
treat cancer of the prostate." (27) Cancer
of the prostate was one disease from which those Kansas boys
had been guaranteed permanent protection.

R.P. Neuman added fresh dimensions to the
discussion by relating the concern with masturbation to
demographic factors. He argued that with the Industrial
Revolution the average age of puberty declined while the
normal age of marriage rose, creating an interval between
childhood and adulthood which had not existed before. This
led to a new concern with child-rearing and a far closer
supervision of sexually mature children, who now spent a
longer interval between puberty and marriage than used to be
the case; the question (rarely spoken) was whether
"adolescents" (as they later became known) were entitled to
sexual activity during this time, and the puritanical
tendencies of the period ensured that the answer was no.
Associated with these developments was a denial that young
children had any sexual feelings at all, with the result that
manifestations like fondling and masturbation were
categorised as pathological and attributed to local
irritation (such as a tight foreskin, worms or "secretions"),
to bad influe nces (particularly at school) or to servants'
tickling a child's genitals as a tranquilliser. As Neuman
puts it

In order to preserve the respectable sexual fantasy that
sex was for adults, not children, and for the purpose of
procreation rather than pleasure, doctors had to explain
masturbation in the very young as the product of certain
organic problems or as the result of bad habits taught by
others. So it was suggested that infants scratched their
genitals because of local irritations caused by uncleanness
or worms. (28)

William Acton's opinion that childhood ought
to be a period of "absolute sexual quiescence" (29) was an important influence here. If any
manifestation of sexual capacity before puberty was
pathological rather than normal, it had to be eliminated, and
corrective surgery, including circumcision, was one of the
usual means. None of this meant that masturbation after
puberty was any less reprobated: Neuman reports the
particularly chilling case of a 23-year old American man who
was diagnosed as suffering from masturbatory insanity in the
1880s, sent to a mental hospital, confined for two months in
a straitjacket and finally subjected to an "operation on his
prepuce calculated to interfere with or stop his vice," as Dr
Spitzka (his gaoler/physician) put it. After this treatment
he did not masturbate again for four months but, strangely,
became no less paranoid. (30) Neuman's
argument also explains why the early sex educators, although
regarded as dangerously advanced for their time, were
actually seeking to curb adolescent sexual activity by
"telling them the truth" about how harmful it was.

In a particularly interesting article which
showed that there were two sides to the familiar Victorian
double standard on sexual morality, Gail Pat Parsons took
issue with feminist historians who argued that while women in
the nineteenth century were the victims of humiliating and
invasive surgical procedures at the hands of (male) doctors)
who left them raw and bleeding, men were treated differently
and with more respect. No, she points out, "men as well as
women suffered excruciating treatment at the hands of
physicians, whose limited knowledge reduced them to punitive,
at times brutal, methods," including chastity devices,
circumcision and castration. (31) She
shows that belief in spermatorrhoea as a real disease was
widely held by the medical profession and not just the
obsession of a few cranks; she points out that "cures" were
often modelled on treatments originally devised for uterine
disorders, including the insertion of needles into the
perineum and testicles, and the urethral cauterisation
recommend ed by Lallemand, favoured by Acton and widely
employed in both Britain and the USA. (32)
Parsons includes a telling discussion of the confused
theories of disease on which the designation of masturbation
as pathological and circumcision as curative were based. Some
doctors favoured the new nerve force theories associated with
Haller and Cullen, while others stuck to the traditional
view, popularised by Tissot but going back to Hippocrates,
Galen and Avicenna, that it was the loss of a precious
animating secretion like semen which debilitated the system.
Acton himself could never decide whether it was the shock of
orgasm to the nervous system or the loss of vital fluid which
did the most damage. (33)

Whatever the mechanism, as Barry Smith
points out in his history of public health in nineteenth
century Britain, doctors after 1870 generally advocated
universal circumcision of boys, preferably done soon after
birth. He does not go into details as to why, but cites
Hutchinson for the main reasons then given: the foreskin was
"a harbour of filth," a source of irritation, an incitement
to masturbation and an obstacle to continence; circumcision
not only corrected these problems, but reduced the risk of
syphilis in the young and cancer in the aged. The endorsement
of the procedure by one of England's most eminent physicians,
and President of the Royal College of Surgeons, carried
weight. (34) In assessing the significance
of masturbation in this list it is not a matter of asking
whether routine circumcision was introduced as a deterrent to
secret vice or as a health measure; the main health benefit
of the procedure was the lessened tendency to masturbation,
then regarded as a serious disease. Most doctors also
believed in the virtue of continence (Acton was particularly
eloquent on this topic), but few aimed explicitly to reduce
sexual pleasure; that was a minor side-effect of a necessary
precaution against seminal loss and nervous excitement. The
new pressures of the modern age were also problems. In the
United States Michael Kimmel identified a crisis in masculine
identity brought about by rapid industrialisation, leading to
the replacement of old models of manhood (the "genteel
patriarch" and the "heroic artisan") with the "marketplace
man." In this model, self-control and conservation of the
body's energies were vital, and masturbation was inevitably
seen as a waste of resources and a threat to success. In a
context of both medical and moral warnings against the
practice, Kimmel reports the invention of various devices
contrived to prevent it, and refers particularly to J.H.
Kelloggs' best-selling prescriptions for clean and healthy
living in the 1880s. These included a list of 39 signs by
which masturbators co uld be detected, and a set of remedies,
including bandaging and caging the genitals; tying the hands
to prevent touching; sewing up the foreskin with silver wire
to prevent erection and create sufficient discomfort to make
sexual impulse unwelcome; and finally circumcision--to be
performed "without administering an anaesthetic, as the brief
pain attending the operation will have a salutary effect upon
the mind, especially if it be connected with the idea of
punishment." (35)

During the 1970s several historians of
childhood and the family realised that modernisation of
attitudes to children was an uneven process: they might have
been freed from their swaddling cloths in the eighteenth
century, but other constraints were soon imposed. Lloyd De
Mause, who was unusual in recognising that circumcision of
boys as carried out by "Jews, Egyptians, Arabs and others"
was a "mutilation of children by adults," noted that parents
began punishing their children for masturbation in the late
eighteenth century and that "doctors began to spread the myth
that it would cause insanity, epilepsy, blindness and death,"
a campaign which reached a climax in the late nineteenth
century. In response circumcision, clitoridectomy and
infibularion were sometimes used as punishment; and all sorts
of restraint devices ... were prescribed. Circumcision became
especially widespread; as one American child psychologist our
it, when a child of two rubs his nose and can't sit still for
a moment, only circumcision works. Another doctor, whose book
was the bible of many an American nineteenth century home,
recommended that little boys be closely watched for signs of
masturbation, and brought in to him for circumcision. (36)

De Mause was more willing than many of his
colleagues to face ugly facts, but a trifle optimistic in
believing that such methods died out in the 1920s.
Nonetheless, such perceptions had some influence on
mainstream historians, such as J.H. Plumb, who felt obliged
to modify his otherwise genial account of childhood in the
eighteenth century with the acknowledgment that the
masturbation phobia meant a partial return to brutality: "by
1800 crimes of unbelievable cruelty were being practised on
young boys in order to cure them, such as circumcision
without anaesthetic." (37) Lawrence Stone
likewise wrote:

Inspired by fears of physical debilitation and even of
insanity, some surgeons in the third quarter of the
nineteenth century were performing clitoridectomy on
masturbating girls and deliberately painful circumcision on
boys, while agitated parents were attaching toothed rings
to the penis and locking adolescents into chastity belts
and even strait-jackets for the night. (38)

In his study of English purity movements,
Edward Bristow noted that during the nineteenth century
doctors joined the quacks in "designing douches to cool the
genitals and devices to restrain them, like the spiked penis
ring," but that they then went a step further to
"clitoridectomies and circumcision as treatment for
masturbation." (39) The same limited
evidence was still being recirculated (mainly drawn from
Spitz and Hare), but the sentiment of outrage was new.

Plumb got the start rather than the end date
wrong, but the relevant point is that the basic information
had emerged from the specialist journals and been published
in mainstream publications with a general readership. Even
though there had been no dedicated study of the issue and
scholars had barely scratched the surface of the medical
literature, by the early 1980s it was well established that
widespread circumcision of young boys was introduced in
English-speaking countries in the late nineteenth century,
and that the main reason for the procedure was the desire to
discourage masturbation in both childhood and adolescence.
Given the horror of circumcision which had prevailed only a
century before, (40) this represents a
revolution in medical attitudes and body-related practices
which demands explanation, so it is both surprising and
disappointing that a major study of the Victorians' love
lives, Peter Gay's much-praised Education of the
senses (1984), does not even mention the phenomenon. Gay
does include a brief discussion of masturbation but does not
go beyond the standard secondary sources: he follows Spitz in
describing some of the remedies as "draconian" and
"sadistic," likewise noting that after the 1850s the
"innocuous cures" (41) favoured by earlier
physicians gave way to "a formidable armamentarium of
mechanical restraints resembling ... mediaeval torture
instruments and surgical procedures like cauterisation of the
sexual organs, infibularion, castration and clitoridectomy."
(42) But Gay exhibits his own double
standard in waxing indignant at the case (cited from Spitz)
of a girl treated for masturbation by the last of these
therapies, while remaining silent about the fact that the
amputation of the foreskin became a standard procedure on
boys. (43) It was one of the most
distinctive and enduring of all the Victorian contributions
to sexual health and bodily management, at least within the
anglophone world, and you might think he would wish to
analyse it in detail. Gay exaggerates the extent to which
warnings against the dire results of masturbation disappeared
after 1910, and also implies that the end of the panic was
partly to the credit of Freud and psychoanalysis. Although
their influence may have been significant, other factors,
such as the acceptance of a valid theory of organic disease
(germs) were probably more important, and it is misleading to
suggest that the campaign against masturbation "was spent."
One of Gay's own sources (Spitz) makes clear that the old
alarm bells were still being rung in the 1930s, while Freud
himself, as Gay acknowledges, had no doubts as to the
pathological nature of the habit and cautioned his own son
against it. (44) Even Lesley Hall, in her
discussion of "brutal remedies for [male] self-abuse"
recommended by the Victorian medical profession, does not
mention circumcision, though she is aware that their aim was
to "guard the penis against improper manipulation" and keep
the organ sufficiently sore "to render erection painful," as
the Lancet put in 1870. (45) Yet many of
the sources she cites (such as James Copland's Dictionary of
practical medicine, 1844-58) are emphatic on the prophylactic
or curative value of circumcision, and letters she quotes
from anxious men to Marie Stopes in the 1920s reveal that
many of them been told at some stage of their lives that
masturbation was a well accepted indication for circumcision.
As CW wrote from Belfast in 1923:

I shall be much obliged for your advice on a "disease"
which has troubled me for the last 10 years, that of
self-abuse. I started it when a boy at school, and it seems
impossible for me to shake off the vice now.... Would you
advise me to be circumcised?.... If you advise circumcision
could I do it myself as I don't wish to approach a doctor
on the subject as I am thoroughly ashamed of myself. (46)

With silences like these, it is hardly
surprising that it was not until the 1990s that scholars
began to acknowledge that forcibly amputating part of boys'
genitals was morally no different from doing the same to
girls. (47) Morris's disapproval
notwithstanding, it was the agitation of anti-circumcision
campaigners in the late 1980s which finally brought the issue
out into the open.

Anticipating this change of mood was
Wallerstein's remarkably temperate study of the survival of
routine infant circumcision in the USA (Britain having
abandoned the practice in the early 1950s, New Zealand in the
1960s, and Australia and Canada relinquishing it more slowly
from the 1970s). Wallerstein includes a discussion of
circumcision as "one of the milder solutions" to the disease
of masturbation and refers to the excitable Dr Remondino as
one of those who popularised the concept of a link between
the foreskin and proneness to the habit. He also points out
that the religious prohibition on masturbation dates back
beyond Christianity to ancient Judaic theologians, many of
whom held it to be a "reprehensible sin" and even a "capital
crime." (48) The most astonishing of
Wallerstein's revelations is that advocacy of circumcision as
a disincentive to masturbation did not die with Emmett Holt.
In 1941 Dr Alan Guttmacher, in a widely-read article in a
popular magazine, recommended it because the simplified penis
was easier to wash, but the aim was moral as well as physical
hygiene: "It does not necessitate handling of the penis by
the infant's mother, or the child himself in later years, and
therefore does not focus the male's attention on his own
genitals. Masturbation is considered less likely." As late as
1956, in Pregnancy and birth, Guttmacher reiterated
his conviction that the "handling of the genitalia" made
necessary by the retention of the foreskin "encourages
masturbation." (49) Summarising his
understanding of the origins of modern circumcision a few
years later, Wallerstein wrote:

So-called "health" circumcision originated in the
nineteenth century, when most diseases were of unknown
etiology. Within the miasma of myth and ignorance, a theory
emerged that masturbation caused many and varied ills. It
seemed logical to some physicians to perform genital
surgery on both sexes to stop masturbation; the major
technique applied to males was circumcision. (50)

It is remarkable how persistent that miasma
has proved.

The first focused attempt to account for the
rise of routine male circumcision in Britain was made by
Ronald Hyam, in his study of sexuality and empire, who
relates the popularity of circumcision at the turn of the
century to three main factors. The first was the fear of
racial decline and falling physical fitness standards, giving
rise to a host of anxieties and counter-measures, including
the belief that circumcision would produce healthier and more
self-confident males and "contribute to the general
improvement of the ... manliness of the future guardians of
empire." The second was the sudden enthusiasm for Jewish
child-rearing practices, especially in response to reports of
a low rate of syphilis and masturbation among Jews. The third
was the necessity for colonial administrators to work in hot
or humid climates where hygiene of the uncircumcised penis
was presumed to be difficult. Hyam notes, in particular, that
it was widely believed that normal males were more
susceptible to venereal disease in hot env ironments, and
that British Army doctors in India were vigorously in favour
of the procedure and operated on their soldiers at the first
sign of trouble. (51) Hyam's account is
not without serious gaps. He does not explain why hygiene in
hot climates came to be seen as a problem only after the rise
of circumcision in a cool climate, nobody having worried
about the issue when the British first entered India in the
eighteenth century; nor why it was believed that removal of
the foreskin would produce healthier males; and he discounts
the supposed value of circumcision in curbing masturbation as
an explanation for its spread. On this point he is clearly
mistaken, and his own discussion makes little sense without
the conviction that masturbation was in itself a major health
hazard and one of the factors contributing to national
decline. The main reason for the sudden enthusiasm for Jewish
child rearing practices was the impression that Jewish boys
did not masturbate, a contention widely debated in the
medical journals of the time but eagerly confirmed by Jewish
doctors, who were understandably delighted that the gentile
world was at last beginning to respect a ritual it had
traditionally despised.

More convincing on this point is Ornella
Moscucci, who shows that circumcision was increasingly
recommended as a cure for male masturbation from the 1850s
onwards. She points out that part of this process was the
demonisation of the foreskin as a source of nervous and
physical disease and agrees with Hyam that circumcision was
central to the late Victorian redefinition of manliness in
terms of self-restraint and cleanliness: "Widely believed to
dampen sexual desire, circumcision was seen positively as a
means of both promoting chastity and physical health." (52) Moscucci also discusses the contrasting
case of female circumcision and clitoridectomy and explains
how, after a brief vogue in the 1860s for treating
masturbation and hysteria, the procedures fell rapidly into
disfavour. Although the latter operation continued to be
performed in the USA until the 1950s, it was effectively
outlawed by the British medical profession and had
disappeared from their surgical repertoire by the 1880s.
Moscucci's article is particularly significant as one of the
first to identify the double standard whereby female
circumcision and clitoridectomy are denounced as mutilations
which must be stopped, while male circumcision is accepted as
a mild and harmless adjustment, even if irrelevant to health.
When the London doctor, Isaac Baker Brown, was expelled from
the Obstetrical Society in 1867 for treating masturbation in
women by clitoridectomy, his opponents referred to the
operation as a "questionable, compromising, unpublishable
mutilation" which would affect the women's sex lives, leave
them permanently maimed and cast an indelible slur on their
honour. Brown defended himself by claiming that masturbation
caused hysteria, epilepsy, mania and, eventually, insanity
and death, and argued that clitoridectomy was no more
mutilating than male circumcision, as proved by the
subsequent pregnancy of one of his patients. His critics did
not dissent from the proposition that masturbation could
provoke the ills he mentioned, but they insisted that the
practice was so rare in women that radical interventions of
this kind were not necessary. The thing that outraged the
society most, and the issue which probably sealed Brown's
disgrace, was the fact that the operation was per formed
without informed or any other kind of consent; but this was
not a consideration which exercised their professional
consciences in the case of little boys. (53) Drawing a modem parallel, Moscucci refers
to an article by a US doctor on the horrors of female genital
mutilation in Africa, (54) and the
commentary of a colleague who reported that her own son was
circumcised, against her wishes and audibly against his own,
at the insistence of her husband, despite paediatric advice
that the operation conferred no health benefits: in other
words, it was a cultural ritual like the ordeal of the
African girls. Referring to Gordon's indignation, she asked
whether those who lived in glasshouses had the right to throw
stones:

Where are the passionate voices of our Western, male
medical anthropologists ... speaking out on the practice of
male genital surgery in the United States? Why isn't male
circumcision also one of the places, to cite Mel Konner,
"where we ought to draw the line"? (55)

It is only the rituals of other peoples that
seem strange and barbarous.

A similar question was asked by Szasz,
returning to the fray in 1996 with a typically provocative
article on the ethics of male routine neonatal circumcision
(RNC). Pointing out that the similarities between RNC and
female genital mutilation are obvious to anybody who has not
been culturally conditioned to accept the former as normal
and the latter as bizarre, he asks: "Why is RNC legal?
Because it is defined as preventive medicine. Why is it
defined as preventive medicine? To avoid having to ban it as
male genital mutilation." (56) Turning to
the origins of the practice, Szasz refers to the
transformation of childbirth in the late nineteenth century,
from home deliveries assisted by (female) midwives to
hospital births managed by (male) physicians, setting the
stage for "the circumcision of the normal male infant by the
obstetrician--a practice rationalised as prophylaxis ...
against ... masturbation." He comments that

Virtually all medical texts at the end of the nineteenth
century and the beginning of the twentieth century
prescribed circumcision for a variety of ills, ranging from
epilepsy and hydrocephalus to malnutrition and
tuberculosis, and confidently asserted that it was a cure
for the "disease" of masturbation. (57)

Szasz commends US critics of RNC for
recognising that the determination to stamp out masturbation
played an important part in the establishment of the
practice, but also points our that masturbation was only one
of "a long line of religious transgressions that were
converted into medical diseases," and refers particularly to
the severity with which it has been condemned in traditional
Jewish theology, which regards it as "a sin more serious than
all the sins of the Torah." (58)

The most focused account of the rise of
routine circumcision in the USA is provided by Frederick
Hodges, who pays particular attention to the significance of
masturbation in this process. Dr Hodges is associated with
groups in the USA which oppose male and female genital
mutilation, and he has been a prominent speaker at Nocirc
conference since 1996--thus one of the mythmakers condemned
by Professor Morris. But there is nothing in his exhaustive
survey of the medical literature and his meticulous
documentation of the medical profession's developing views
and practices to suggest that he is inventing anything; if
the conclusions of his research seem highly-coloured or
gruesome, that is in the nature of the source material, which
does yield dark truths which contemporary advocates of
routine circumcision naturally find embarrassing. It is not,
however, the cruelty or moralism of early enthusiasts which
Hodges finds most disturbing, but their sloppy reasoning,
poor science, lack of ethics, and the authoritarian zeal
which many of them brought to their task. A telling quote is
this by Dr Spratling in 1895:

In all cases [of masturbation] ... circumcision is
undoubtedly the physicians' closest friend and ally.... To
obtain the best results one must cur away enough skin and
mucous membrane to rather put it on a stretch when
erections come later. There must be no play in the skin
after the wound has thoroughly healed, but it must fit
tightly over the penis, for should there be any play the
patient will be found to readily resume his practice, not
begrudging the time and extra energy required to produce
the orgasm. (59)

Spratling went on to suggest that a
supplementary circumcision might be necessary as the
remaining skin stretched.

Hodges traces the origins of routine
circumcision to the masturbation phobia of the eighteenth
century, but more specifically to theories of degenerative
disease and reflex neurosis which held that disturbances of
nervous equilibrium could cause disease, and which thus
targeted sensitive parts of the body as the guilty parties.
In this scenario, erotic sensation was redefined as
irritation, orgasm as convulsion and erection as priapism; as
the most sensitive part of the penis, the foreskin was
particularly suspect. In the work of Lallemand and his many
followers the normal male sexual function--the production and
emission of sperm--was categorised as a life-threatening
disease which demanded drastic treatment. If all this sounds
too incredible, we must remember that it was a time when the
causes of most diseases were not understood, treatments were
ineffective, and mortality (especially in children) was high;
belief in witchcraft or spirits as causes of illness had been
discredited by the Enlightenment, and m asturbation at least
offered a materialist explanation. At the same time,
theologians and other public moralists were advocating
increased sexual purity, a demand which grew more insistent
in the nineteenth century and reached a crescendo in the
syphilis scare of the early twentieth. Lallemand recommended
circumcision for serious cases of spermatorrhoea, and this
idea caught on in the USA, where castration (not unusual in
cases of epilepsy and insanity) was obviously too extreme a
measure to become popular. The theory of the reflex neurosis
was developed by the distinguished orthopaedic surgeon, Lewis
Sayre, who claimed that many cases of muscular paralysis were
caused by a long, tight or otherwise constricted prepuce and
could be cured by circumcision; the same result in girls
could be achieved by clitoridectomy. In seeking evidence for
the effects of circumcision, the medical profession naturally
looked to the Jewish community, whose own doctors were only
too happy to assure them that Jewish boys did not ma
sturbate, or not as much as the uncircumcised. As Dr M.J.
Moses advised:

As an Israelite, I desire to ventilate the subject.... I
refer to masturbation as one of the effects of a long
prepuce; not that this vice is entirely absent in those who
have undergone circumcision, though I never saw an instance
in a Jewish child of very tender years except as the result
of association with children whose covered glans have
naturally impelled them to the habit. (60)

Support for preventive circumcision was
strengthened by reports that Jews also presented with lower
rates of syphilis and cancer of the penis, and it was assumed
that the absence of the foreskin must account for the
difference. These were powerful selling points in Abraham
Wolbarst's influential call for universal male circumcision
in 1914, but he was equally insistent on its value as a
"prophylactic against masturbation." (61)
Among the most disturbing of Hodges' findings is the
insularity of the American medical profession, which clung to
the old theory of "congenital phimosis" long after it had
been debunked in Britain and Europe; and among the most
astonishing is that masturbation was still being listed as an
indication for circumcision as late as the 1970s. Although
paediatricians had dropped this notion, the third edition of
a standard urological textbook, Campbell's urology (1970)
stated: "Parents readily recognise the importance of local
cleanliness and genital hygiene in their children and are
usually ready to adopt measures which may avert masturbation.
Circumcision is usually advised on these grounds." (62)

The influence of politically inspired
scholars like Hodges is apparent in the illuminating research
of David Gollaher on the history of circumcision, and
particularly in the difference between his path-breaking
journal article of 1994 and his later book. In his article
Gollaher focuses on the discoveries of Lewis Sayre and his
subsequent theories on the link between problem foreskins and
various paralytic illnesses, codified in his book On the
deleterious results of a narrow prepuce and preputial
adhesions (1888). He shows that other doctors were quick to
take up Sayre's findings and push them further. Soon adherent
prepuces were being discovered all over the country and their
removal alleviating the symptoms of numerous childhood
complaints; one doctor reported a case of "brass poisoning
completely cured." Dr Norman Chapman suggested that the
incidence of adhesive foreskins was probably higher than
people realised; since "a long and contracted foreskin" was
so often a source of "secondary complications," he went on to
propose that it was "always good surgery to correct this
deformity ... as a precautionary measure, even though no
symptoms have as yet presented themselves." Chapman suggested
in 1882 that Christians had much to learn from Jews in this
respect:

Moses was a good sanitarian, and if circumcision was more
generally practised at the present day, I believe that we
would hear far less of the pollutions and indiscretions of
youth; and that our daily papers would not be so profusely
flooded with all kinds of cures for loss of manhood.

As Gollaher observes, this declaration
represents an important transition in thought: circumcision
becomes not just a treatment for existing problems, but an
anticipation designed to prevent possible "complications" in
the future. Thus the preventive career of the operation was
launched. (63)

Gollaher discusses masturbation as a
separate causative factor, noting Remondino's convictions
that the foreskin was always to blame for childhood
masturbation and that "the children of circumcised races"
were neither as prone to the habit nor as susceptible to wet
dreams. He also reports that childcare handbooks were
recommending circumcision to prevent the vile habit of
masturbation" from the mid-1890s. (64)
Gollaher does not integrate masturbation with the theory of
reflex neuroses which lay behind Sayre's adoption of
circumcision as a cure for many nervous ailments, but the
"irritabilities" supposedly provoked by either a constricted
foreskin or the act of masturbation were remarkably similar,
and each had such equally harmful effects that it was
difficult to distinguish the two aetiologies: in the case of
one teenage patient, it was suspected that the real cause of
his paralysis was in fact masturbation. (65) What is apparent throughout Gollaher's
discussion is that a puritanical animus against sexual in
dulgence was woven deeply into the texture of the doctors'
clinical arguments and that it is impossible to separate
their moral theology from their medical science. The same
doctor who could not explain why circumcision cured brass
poisoning nonetheless resolved that whether it be curative or
not it is conservative, and removes one source of irritation
from an exquisitely sensitive organ. I would favour
circumcision, however, independent of existing disease, as a
sanitary precaution.... (1) The exposure of the glans to
friction etc. hardens it, and renders it less liable to
abrasion in sexual intercourse, and consequently venereal
ulcer. (2) It is acknowledged to be useful as a preventive of
masturbation. (3) It certainly renders the accident of
phymosis and paraphymosis impossible. (4) It prevents the
retention of sebaceous secretion and consequent balanitis.
(5) It probably promotes continence by diminishing the
pruriency of the sexual appetite. (66)

Two of the five points are not medical
considerations at all, but mere moral assumptions.

In his more wide-ranging book on the history
of circumcision Gollaher follows the same line of argument,
but his discussion of masturbation is considerably expanded,
and it plays a more central role in his explanation for the
rise of routine circumcision. He cites Hutchinson, Kellogg
and paediatricians such as Angel Money as fervent advocates
of the intervention, and notes the importance of the Jewish
example in encouraging doctors to believe that circumcised
boys did not masturbate. He follows Szasz in recognising the
severity of the ancient Jewish prohibition against the
practice, notes the Lancet's discoveries in the 1860s that
masturbation and bed-wetting were rare in Jewish communities,
and describes M.J. Moses as a "crusader against the foreskin
as the primary cause of masturbation." He also appreciates
that doctors around the turn of the century were perfectly
aware that circumcision reduced sexual pleasure and that they
approved of it for precisely this reason. (67) The inescapable conclusion of his t
horoughly documented studies is that deterrence of
masturbation was a major motivation for the introduction of
widespread male circumcision in the late Victorian
period.

Whatever the balance between the various
factors leading to this triumph, it is obvious that such an
immense shift in medical thinking needed the conjunction of
many causes. It is equally clear that routine circumcision
arose from a mire of ignorance and now discredited theories
of disease, including outright quackery (the pathologisation
of male sexuality as spermatorrhoea); medical delusions
(theories of reflex neuroses and masturbatory illness);
puritanical zeal (the determination to suppress sexual
activity in childhood and adolescence); loss of knowledge
about the normal anatomy and physiology of the penis, with
the result that the adhesion and non-retractability of the
foreskin in young boys was classified as a congenital defect
instead of being recognised as its natural condition; (68) and wild hopes that a miracle cure had
been found for such rapacious diseases as tuberculosis,
syphilis, polio and cancer. Whether the desire to prevent
masturbation was 30, 60 or 90 per cent responsible for the
institut ion of routine circumcision, there is no basis for
the claim that the connection is a lie put about by
anti-circumcision activists.

In summary, it can be seen that doctors in
English-speaking countries introduced widespread circumcision
of male infants in the late nineteenth century. At the time
this innovation was justified largely in terms of
discouraging masturbation, then regarded as a serious disease
in its own right and as the cause of many more, but this
rationale was increasingly overlaid by others in the early
twentieth century, including protection against syphilis and
cancer, freedom from phimosis (seen as a problem mainly
because it was thought to provoke masturbation), and a
general contribution to both moral and physical hygiene. To
justify circumcision on the ground that it discouraged
masturbation was to acknowledge that the operation reduced
the sensitivity of the penis and curtailed sexual pleasure, a
powerful argument to use at a time when most respectable
people believed that excessive sexual indulgence was morally
wrong as well as physically harmful; mainstream paediatric
and child care manuals continued to assert the value of
circumcision as a disincentive to masturbation right up until
the 1950s. With the advance of the sexual revolution in the
1960s (by which time routine circumcision survived only in
the USA, Canada and Australia) this ceased to be a strong
selling point; if a doctor there wanted to persuade parents
to let him amputate part of their baby's penis he now had to
reassure them that the procedure would significantly increase
health without noticeably reducing sexual functionality or
pleasure, and the original logic of its introduction was lost
in a welter of social, aesthetic and medical
rationalisations. At the scholarly level, the significance of
the original link between masturbation and circumcision was
rediscovered in the 1950s, when belief in the harmful effects
of the former was declining, and as medical historians began
to investigate the origin, course and effects of the onanism
scare during the eighteenth and nineteenth centuries.

ENDNOTES

(1.) Many tribal societies
practised other forms of bodily alteration (scarification,
knocking out teeth, subincision, piercing etc) usually as
part of initiation rites, and most of those which practised
male circumcision also practised forms of female genital
mutilation. For an introduction to a considerable and
inconclusive literature, see David L. Gollaher,
Circumcision: A History of the World's Most
Controversial Surgery (New York, 2000), Ch. 3.

(2.) J.D. Oriel, Scars of
Venus: A History of Venereology (London, 1994), 118.

(6.) Mabel Huschka, "The Incidence
and Character of Masturbation Threats in a Group of Problem
Children," Psychoanalytic Quarterly, Vol. 7 (1938),
338-56. [Abstract]

(7.) Hugh O'Donnell, "A Century of Circumcision in America,"
unpublished paper, Sydney, 2001. O'Donnell based his
calculations on US census data and figures on historical
circumcision rates given in Edward Wallerstein,
Circumcision: An American Health Fallacy (New York,
1980), 216-17.

(8.) Jean Stengers and Anne van
Neck, Masturbation: The History of a Great Terror
(New York, 2001), 104. The Struwwelpeter stories were
widely translated: see "The story of little suck-a-thumb"
in A Book of Nonsense, (London, 1927), 157-8. You
don't need to have read Freud to see thumb-sucking as a
symbol of masturbation.

(9.) Ian Gibson, The English
Vice: Beating, Sex and Shame in Victorian England and
After (London, 1978), 294.

(10.) Michael Stolberg has
identified the correct publication date of Onania and
located it within the traditions of moral tract writing and
quack medicine, but notes that its medical assertions were
novel and copied from a contemporary treatise on venereal
disease. See his "Self-pollution, moral reform and the
venereal trade: Notes on the sources and historical context
of Onania," Journal of the History of Sexuality,
Vol. 9 (2000), 37-61. [Abstract]

(20.) Robert H. MacDonald, "The
Frightful Consequences of Onanism: Notes on the History of
a Delusion," Journal of the History of Ideas, Vol.
28 (1967), 423-31. [Abstract]

(21.) H. Tristram Engelhardt,
"The Disease of Masturbation: Values and the Concept of
Disease," Bulletin of the History of Medicine, Vol.
48 (1974), 244-5.

(22.) Arthur N. Gilbert,
"Doctor, Patient, and Onanist Diseases in the Nineteenth
Century," Journal of the History of Medicine, Vol.
30 (1975), 217-234.

(23.) Quoted in Lesley Hall,
"'The English have hot water bottles': The morganatic
marriage between sexology and medicine in Britain since
William Acton," in Roy Porter and Mikulas Teich (eds),
Sexual Knowledge, Sexual Science: The History of
Attitudes to Sexuality (Cambridge, 1994), 353.

(26.) Hamowy, 245. In his later
book, Sex Hygiene for the Male (1912) Lydston
stated: "Circumcision promotes cleanliness, prevents
disease, and by reducing over-sensitiveness of the parts
tends to relieve sexual irritability, thus correcting any
tendency ... to improper manipulations of the genital
organs and the consequent acquirement [sic] of evil sexual
habits, such as masturbation." Abraham Wolbarst quoted this
passage is in his clarion call for universal male
circumcision in 1914 ("Universal circumcision as a sanitary
measure," Journal of the American Medical
Association, Vol. 62 [1914], 95). In his home medical
guide George Beard devoted considerable space to modern
nervous disease, including neurasthenia (almost his own
invention), seminal emissions and self abuse, and in this
context focused on the foreskin. Following Lewis Sayre
(discussed below) he reported that most sufferers from
nervous disease had an abnormal prepuce, for the obvious
reason that "a redundant, elongated prepuce, covering the
gland [sic] and pressuring upon it, acts as an irritant to
the whole system." Circumcision was required to relieve the
pressure and thus cure the consequent illnesses. (George
Beard, The New Cyclopaedia of Family Medicine--Our Home
Physician: A Popular Guide to the Art of Preserving Health
and Treating Disease [Sydney, 1884], 882-9.)

(33.) Ejaculation never and
orgasm rarely occurs as a result of the fondling and
manipulation naturally undertaken by children before
puberty, a fact which emphasises the point that the real
objection to masturbation was moral, not medical. In trying
to explain how masturbation caused organic disease, Tissot
and his followers drew eclectically on the Galenic humoral
tradition, revived in the eighteenth century by Hermann
Boerhaave, and the new theories of nervous force developed
by Hailer without showing awareness of their
incompatibility. See Stengers, Ch. 6.

(34.) F.B. Smith, The
People's Health 1830-1910 (Canberra, 1979), 298-9.
Although Smith cites Hutchinson's "Circumcision as a
Preventive of Masturbation," he seems to be quoting from a
shorter paper, "A Plea for Circumcision" (Archives of
Surgery, Vol. II [1890], 15). This was widely reprinted
in other medical journals, e.g. British Medical
Journal 1890 (2), 769.

(39.) Edward J. Bristow, Vice
and Vigilance: Purity Movements in Britain since 1700
(London, 1977), 128. Bristowal so notes (p. 132) that
purity campaigners after the l880s sometimes urged parents
to have their sons circumcised if they suspected them of
masturbation.

(41.) As already noted, some
early cures for spermatorrhoea--cauterisation of the
urethra with silver nitrate or other caustic substances and
castration--were hardly "innocuous"; in 1861 the
Lancet reported the death of a young man as a result
of the cauterisation procedure administered by Richard
Dawson, author of An essay on spermatorrhoea and urinary
deposits: see Lancet 1861 (2), 635-7.

(44.) Gay, 308-9; see also
Stengers, 138-41, Szasz, 224-6, and Richard Webster, Why
Freud was Wrong: Sin, Science and Psychoanalysis (1995)
(London, 1996), 586. At a meeting of the Vienna
Psychoanalytic Society in February 1912, Freud was reported
as stating: "The opinion that masturbation is harmful finds
support in observations made by an absolutely objective
critic who traced back the later stultification of Arab
youths to their masturbation, which was excessive and
totally uninhibited" (cited in Stengers, n. 17, 222).

(45.) Lesley Hall, "Forbidden by
God, Despised by Men: Masturbation, Medical Warnings, Moral
Panic and Manhood in Great Britain, 1850-1950," in John C.
Fout (ed.), Forbidden History: The State, Society and
the Regulation of Sexuality in Modern Europe (Chicago,
1992), 296.

(46.) Quoted in Hall 1992,
p.312. I am grateful to Dr Lesley Hall, owner of the
invaluable Hist-Sex list for historians of sexuality, for
sending me a more complete version of this letter than the
one she quotes in her paper.

(58.) Szasz 1996, 141. For an
illuminating discussion of Jewish attitudes to
masturbation, see David Biale, Eros and the Jews: From
Biblical Israel to Contemporary America (New York,
1992).

(59.) E.J. Spratling,
"Masturbation in the Adult," Medical Record, 1895,
quoted in Frederick Hodges, "A Short History of the
Institutionalization of Involuntary Sexual Mutilation in
the United States," in George C. Denniston and Marilyn
Fayre Milos (eds), Sexual Mutilations: A Human
Tragedy (New York, 1997), 23.

(60.) M.J. Moses, "The Value of
Circumcision as a Hygienic and Therapeutic Measure," New
York Medical Journal, 1871, quoted in Hodges, 23.

(68.) This was perfectly well
understood by English physicians up until William Acton,
who wrote: "In childhood the penis is naturally small, with
the foreskin pointed, and nor only completely covering the
glans, but even extending beyond it. The attempt to uncover
the glans is attended with difficulty in consequence of a
natural phymosis, and similarly the process of recovering
the glans owing to a natural paraphymosis cannot be
accomplished without ... violence.... The mucous membrane
is soft and flaccid, and ... free from the secretion called
smegma by which it is covered in after life" (Acton 1903,
1). The errors of his successors were corrected by Douglas
Gairdner, "The
fate of the foreskin: A study of circumcision,"
British Medical Journal, (1949) (2), 1433-37. See
also C.J. Cold and J.R. Taylor, "The
prepuce," BJU International, Vol. 83 (1999),
Supplement 1, 34-44.